HPV vaccination protects against oral cavity HPV infections in young women

  • Schlecht NF e tal
  • JAMA Network Open
  • 26 Oct 2019

  • International Clinical Digest
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Takeaway

  • HPV in the oral cavity is common among sexually active female adolescents, but declines with age, time since first sexual activity.  
  • Editorial.

Why this matters

  • Consider postdiagnosis HPV testing in the oral cavity.
  • Continue to encourage HPV vaccine uptake in eligible adolescent, young adult patients.

Key results

  • 1259 participants, 50.7% (638), 45.2% (569), 3.4% (43), respectively, of African-American, Hispanic, unspecified race/identify.
  • Median age 18 years (range 13-21).
  • >50% reported first sexual experience at median 14.8 years.
  • 6.2% (78; 95% CI, 4.9%-7.7%) had oral HPV; greatest prevalence detected at age 16 for all types (10.5%, 16/153), oncogenic types (3.9%, 6/153).
  • Significant decline in oral HPV detection with years since first sexual activity (>4 vs 1 year, OR 0.45 [P=.03 for trend]).
  • HPV prevalence (all types) was 83% lower in vaccinated vs unvaccinated (OR 0.17; 95% CI, 0.04-0.68), remaining protective after adjusting for concurrent detection of 4vHPV cervical HPV types (OR 0.20; 95% CI, 0.04-1.00).
  • 88% of detected oral HPV cleared

Study design

  • Longitudinal cohort study evaluating oral HPV prevalence in sexually active urban female adolescents, association with HPV vaccine receipt, October 2007-March 2017.
  • Funding: NIH, NCI.

Limitations

  • Single site.
  • Insufficiently powered to assess HPV acquisition risk, vaccine benefit/HPV type.